New Strategy for Detection of Subclinical Coronary Atherosclerosis in Asymptomatic Patients With Type 2 Diabetes Based on Cardiac Multi-Detector Computed Tomography and Treadmill Test

Hae Chang Jeong; Inna Kim; Keun Ho Park; Doo Sun Sim; Young Joon Hong; Ju Han Kim; Myung Ho Jeong; Jeong Gwan Cho; Jong Chun Park; Yun Hyeon Kim; Hyun Ju Seon; Jae Dong Moon; Youngkeun Ahn

doi:10.1253/circj.CJ-13-1038

Ischemic Heart Disease

New Strategy for Detection of Subclinical Coronary Atherosclerosis in Asymptomatic Patients With Type 2 Diabetes Based on Cardiac Multi-Detector Computed Tomography and Treadmill Test

Hae Chang Jeong, Inna Kim, Keun Ho Park, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Yun Hyeon Kim, Hyun Ju Seon, Jae Dong Moon, Youngkeun Ahn

Author information

Hae Chang Jeong
Department of Cardiology, Chonnam National University Hospital
Inna Kim
Department of Cardiology, Chonnam National University Hospital
Keun Ho Park
Department of Cardiology, Chonnam National University Hospital
Doo Sun Sim
Department of Cardiology, Chonnam National University Hospital
Young Joon Hong
Department of Cardiology, Chonnam National University Hospital
Ju Han Kim
Department of Cardiology, Chonnam National University Hospital
Myung Ho Jeong
Department of Cardiology, Chonnam National University Hospital
Jeong Gwan Cho
Department of Cardiology, Chonnam National University Hospital
Jong Chun Park
Department of Cardiology, Chonnam National University Hospital
Yun Hyeon Kim
Department of Radiology, Chonnam National University Hospital
Hyun Ju Seon
Department of Radiology, Chonnam National University Hospital
Jae Dong Moon
Health Promotion Center, Chonnam National University Hwasun Hospital
Youngkeun Ahn
Department of Cardiology, Chonnam National University Hospital

Keywords: Atherosclerosis, Diabetes mellitus, Multi-detector computed tomography

JOURNAL FREE ACCESS

2014 Volume 78 Issue 3 Pages 671-678

DOI https://doi.org/10.1253/circj.CJ-13-1038

Browse “Advance online publication” version

Details

Abstract

Background: The current screening strategy for subclinical coronary atherosclerosis in asymptomatic diabetic patients is not sufficient in real clinical practice. A new strategy was investigated that uses cardiac multi-detector computed tomography (MDCT) and a treadmill test (TMT). Methods and Results: A total of 445 self-referred asymptomatic diabetic patients underwent cardiac MDCT. The treatment plan was determined according to the new strategy that uses MDCT and TMT. All patients underwent clinical follow-up and cardiac events were investigated. The incidence of subclinical atherosclerosis was 49.4%. The group without plaque underwent clinical follow-up without treatment and did not experience any cardiac events in 675.1 person-years of follow-up. Among patients with subclinical atherosclerosis without significant stenosis (n=136) who received medical treatment only, 11 patients experienced cardiac events over 326.4 person-years. The patients with significant stenosis (n=84) underwent TMT. Patients with positive TMT (n=14) underwent coronary angiograms and revascularization therapy was performed in all of them over 39.2 person-years. Patients with negative TMT (n=70) underwent medical treatment, and 27 of them experienced cardiac events. The incidence of cardiac death was 0% during 3 years of follow-up. Conclusions: The new strategy for detecting subclinical atherosclerosis on MDCT combined with TMT may be a useful method for minimizing the mortality rate from cardiovascular disease in asymptomatic diabetic patients. (Circ J 2014; 78: 671–678)

Corresponding author

Register with J-STAGE for free!